Urinary incontinence (UI) is a highly prevalent condition that impairs quality of life, health, and economic well-being. Prevalence rates vary widely due to different definitions of UI and populations studied, ranging between 25 and 45% in community living women and 5 to 32% in men [1]. Emerging evidence suggests that UI is influenced by stressors across the life course, such as adverse childhood experiences (ACEs), lower income, and mental ill-health, but these relationships remain understudied [2]. A life course perspective is increasingly recognized as essential for prevention focused, person-centred continence care [3]. This study aimed to determine the prevalence of UI in Canadian community-living adults (aged ≥ 45 years), changes in prevalence over time, and the social, psychological, health, and economic factors associated with UI.

This study used data from the Canadian Longitudinal Study on Aging (CLSA), which includes over 50,000 participants aged 45 to 85 at baseline (2011). We used data from follow-up 1 (FUP1) and follow-up 2 (FUP2) collected in 2015-2018 and 2018-2021, respectively. UI was self-reported: ‘Have you ever experienced UI?’. Study variables included: sociodemographic variables (e.g., age, sex, income), ACEs, functional limitations, chronic conditions, cognitive impairment, depressive symptoms, nutritional risk, physical activity, material and social deprivation, social support, and social participation (refer to Table 1). CLSA inflation weights were used to estimate UI prevalence in the Canadian population. Descriptive analysis was employed to describe UI/factor associations, the Newcombe (Wilson-based) Method was used to explore differences in subgroup proportions, and t-tests for differences in means.

Among all participants, UI prevalence was 16.8% at FUP1, increasing to 21.3% at FUP2. We compared UI proportions in various subgroups at FUP1 (n=44,815), with significantly higher differences (alpha = 0.05) seen in the following groups (refer to Table 2):
-	sex (females versus males), 
-	annual household income (less than $20,000 versus $20,000+), 
-	ACEs (≥1 ACEs versus no ACEs), 
-	functional limitations in activities of daily living and instrumental activities (≥1 limitations versus no limitations), 
-	arthritis (those with versus without arthritis),
-	bowel incontinence (those with versus without bowel incontinence),
-	diabetes (those with versus without diabetes), 
-	mental health conditions (those with mood/anxiety/positive depression screen versus not),
-	chronic conditions (those with a higher versus lower number of chronic conditions),
-	nutritional risk (those with versus without risk),
-	physical activity (those less physically active versus more active).

Prevalence of UI in Canadian adults is increasing. Association of UI with chronic conditions, such as diabetes and depression, supports previous research. Novel findings include relationships of UI and lower income, nutritional risk, and ACEs, suggesting the impact of social determinants of health and life course factors on UI.

Improved understanding of factors related to UI signals the need for upstream public health interventions to address potentially modifiable factors in the development and management of UI.

Milsom, I., et al., Epidemiology of urinary incontinence and other lower urinary tract symptoms, pelvic organ prolapse and anal incontinence, in Incontinence, L. Cardozza, et al., Editors. 2023, ICS and ICUD. p. 13-130.
Lee, J.A., et al., Associations between socioeconomic status and urge urinary incontinence: An analysis of NHANES 2005 to 2016. The Journal of Urology, 2020. 203(2): p. 379-384.
Harlow, B.L., et al., The prevention of lower urinary tract symptoms (PLUS) research consortium: a transdisciplinary approach toward promoting bladder health and preventing lower urinary tract symptoms in women across the life course. Journal of Women's Health, 2018. 27(3): p. 283-289.

Continence 19S (2026) 102614
DOI: 10.1016/j.cont.2026.102614